SUMMARY:
1. The objective of the study was to know the etiology and clinical profile including radiological features and ECG changes in chronic corpulmonale.
2. 50 cases of chronic corpulmonale, of which 40 were males and 10 were female were included in the study.
3. Chronic corpulmonale was predominantly found to be a disease of middle and older age groups with a peak incidence in the fifth and sixth decades.
4. Smoking plays a significant role in precipitating and aggravating the primary lung disease and hence corpulmonale.
5. Thorough interrogation with reference to symptoms of
breathlessness, cough with expectoration swelling of the feet etc, was done.
6. Detailed clinical examination was carried out to confirm the diagnosis of corpulmonale and to find out any associated evidence of lung parenchymatous lesion. Nine cases had sequelae of pulmonary tuberculosis Six cases had bilateral bronchiectasis and 5 cases had bronchial asthma 1 case had kyphoscoliosis and 2 had ILD. The remaining cases were chronic bronchitis with or without emphysema.
7. Chest X-ray was done in all cases. Chest X-ray showed details of relevant clinical profile. Thus the changes included chronic bronchitis with or without emphysema (54%), braonchiectasis (12%). Bilateral pulmonary tuberculosis with fibrosis with or without compensatory emphysema (18%). One case (2%) showed kyphoscoliosis with gross thoracic deformity. Two (4%) had reticulo nodular pattern suggestive of ILD. CT scan was done in necessary cases.
8. In all the clinically proved cases of corpulmonale Electro cardiogram was recorded in all the 12 leads along with V3R, V4R. It was recorded at a speed of 25 mm/sec with standardization of 1 mv β 10 mm.
9. ECG varies between normal (only sinus tachycardia) to evidece of dominant right ventricular activity. The latter was evidenced by RVH (16%). Righ Axis deviation (54%) RBBB (20%) and P β Pulmonale (28%). One case had ventricular ectopics.
10. Response to treatment was better in patients with symptoms of lesser duration compared to patients with symptoms of longer duration.
CONCLUSION:
The major cause of chronic cor pulmonale in our study was found to be Chronic Obstructive Pulmonary Disease followed by sequelae of pulmonary tuberculosis. Smoking formed the major and most important causal association in the present study